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Title: Acute upper gastrointestinal bleeding due to portal hypertension in children: What is the best timing of endoscopy?
Authors: BELLO, Fernanda Paixao SilveiraCARDOSO, SilviaTANNURI, Ana CristinaPRETO-ZAMPERLINI, MarcelaSCHVARTSMAN, ClaudioFARHAT, Sylvia Costa Lima
Citation: DIGESTIVE AND LIVER DISEASE, v.54, n.1, p.63-68, 2022
Abstract: Objective: To compare initial clinical/laboratory parameters and outcomes of mortality/rebleeding of endoscopy performed < 12 h(early UGIE) versus endoscopy performed after 12-24h(late UGIE) of ED admission in children with acute upper gastrointestinal bleeding(AUGIB) due to portal hypertension. Methods: This is a retrospective cohort study. From January 2010 to July 2017, medical records of all children admitted to a tertiary care hospital with AUGIB due to portal hypertension were reviewed until 60 days after ED admission. Results: A total of 98 ED admissions occurred from 73 patients. Rebleeding was identified in 8/98(8%) episodes, and 9 deaths were observed. UGIE was performed in 92(94%) episodes, and 53(58%) of them occurred within 12 h of ED admission. Episodes with early UGIE and late UGIE were similar in terms of history/complaints/laboratory data at admission, chronic liver disease associated, AUGIB duration, and initial management. No statistically significant associations were found between early UGIE and the outcomes of death/rebleeding and prevalence of endoscopic hemostatic treatment (band ligation or sclerotherapy) compared to late UGIE. In the multivariable logistic regression model, the endoscopic hemostatic treatment showed a negative association with early UGIE(OR = 0.33;95%CI = 0.1-0.9; p = 0.04). Conclusions: This study suggests that in pediatric patients with AUGIB and portal hypertension, UGIE may be performed after 12-24 h without harm to the patient, facilitating better initial clinical stabilization/treatment and optimization of resources.
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Artigos e Materiais de Revistas Científicas - FM/MPE
Departamento de Pediatria - FM/MPE

Artigos e Materiais de Revistas Científicas - HC/ICr
Instituto da Criança - HC/ICr

Artigos e Materiais de Revistas Científicas - LIM/05
LIM/05 - Laboratório de Poluição Atmosférica Experimental

Artigos e Materiais de Revistas Científicas - LIM/30
LIM/30 - Laboratório de Investigação em Cirurgia Pediátrica

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